Alonso Nivaldo, Massenburg Benjamin B, Galli Rafael, Sobrado Lucas, Birolini Dario
- Faculty of Medicine at the University of São Paulo, Department of Surgery, São Paulo, São Paulo State, Brazil.
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts, United States of America.
Rev Col Bras Cir. 2017 Mar-Apr;44(2):202-207. doi: 10.1590/0100-69912017002016.
to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care.
data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments. Density and distribution of the medical workforce and healthcare facilities were calculated, and the geographic regions were analyzed using the public private inequality index.
Brazil has an average of two physicians for every 1,000 inhabitants, who are unequally distributed throughout the country. There are 22,276 board certified general surgeons in Brazil (11.49 for every 100,000 people). The country currently has 257 medical schools, with 25,159 vacancies for medical students each year, with only around 13,500 vacancies for residency. The public private inequality index is 3.90 for the country, and ranges from 1.63 in the Rio de Janeiro up to 12.06 in Bahia.
A significant part of the local population still faces many difficulties in accessing surgical care, particularly in the north and northeast of the country, where there are fewer hospitals and surgeons. Physicians and surgeons are particularly scarce in the public health system nationwide, and better incentives are needed to ensure an equal public and private workforce.
分析来自国家公共卫生系统（SUS）的巴西人口医学数据，该系统为全体民众提供免费的全民健康覆盖，并讨论所揭示的问题，尤其关注外科护理。
数据来自公共卫生数据库，包括医学人口统计学、巴西联邦医学委员会、巴西地理与统计研究所及国家医疗机构数据库。计算了医疗劳动力和医疗设施的密度与分布，并使用公私不平等指数对地理区域进行了分析。
巴西平均每1000名居民中有两名医生，且分布不均衡。巴西有22276名获得委员会认证的普通外科医生（每10万人中有11.49名）。该国目前有257所医学院校，每年有25159个医学生空缺名额，而住院医师空缺名额仅约13500个。该国的公私不平等指数为3.90，里约热内卢为1.63，巴伊亚高达12.06。
当地很大一部分人口在获得外科护理方面仍面临诸多困难，尤其是在该国北部和东北部，那里医院和外科医生较少。全国公共卫生系统中医生和外科医生尤其短缺，需要更好的激励措施来确保公私劳动力平等。
